The rapid increase in numbers of older people, combined with a decrease in
financial support for human and health services, has led to values and policy
dilemmas in home care of the frail elderly. A consideration offour sets of American
values—democratic utilitarianism, individual rights and self-fulfillment, equality,
and efficiency in work and production—is made as they apply to policies and
programs relating to home care. It is important for those involved in gerontological
education, research, and practice to rethink home care policies in order to examine
the value-laden assumptions upon which these policies are based. Such examination may lead to a remediation of the dilemmas currently encountered by clients
and caregivers in the home care situation.
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References
1.
Achenbaum, W. A. (1983). Shades of gray: Old age, American values and federal policies since 1920. Boston: Little, Brown.
2.
Beattie, W. M. ( 1977). Aging and social services. In R. H. Binstock & E. Shanas (Eds.), Handbook of aging and the social sciences (pp. 619-635). New York: Van Nostrand Reinhold.
3.
Brody, E. M. (1985). Parent care as a normative family stress. Gerontologist, 25, 19-29.
4.
Brody, E. M., Johnsen, P. T., & Fulcomer, M. C. ( 1984). What should adult children do for elderly parents: Opinions and preferences of three generations of women. Journal of Gerontology, 39, 736-746.
5.
Cantor, M. H. (1983). Strain among caregivers: A study of experience in the United States. Gerontologist, 23, 597-604.
6.
Daniels, N. (1983). Justice between age groups: Am I my parents' keeper?Milbank Memorial Fund Quarterly/Health and Society, 61(3), 489-522.
7.
Davis, K., & Rowland, D. (1983). Uninsured and underserved: Inequities in health care in the U. S. In President's Commission for the Study of Ethical Problems in Medicine and Biomedical and Behavioral Research. Securing access to health care (Vol. 3). Washington, DC: Government Printing Office.
8.
Estes, C. L., Gerard, L. E., Zones, J. S., & Swan, J. H. (1984). Political economy, health and aging. Boston: Little, Brown.
9.
Fein, R. (1980). Social and economic attitudes shaping American health policy. Milbank Memorial Fund Quarterly/ Health and Society, 58(3), 349-385.
10.
Finch, W. A. (1976, September). Social workers vs. bureaucracy. Social Work, pp. 370-375.
11.
Goffman, E. (1961). Asylums: Essays on the social situation of mental patients and other inmates. Garden City, NY: Anchor Books.
12.
Horejsi, C. R. (1983). Social and psychological factors in family care. In R. Perlman (Ed.), Family home care: Critical issues for services and policies. New York: Haworth Press.
13.
Kent, D. P. (1965). Aging—Fact or fancy. Gerontologist, 5(2).
14.
Lindblom, C. E. (1968). The policy making process. Englewood Cliffs, NJ: Prentice-Hall.
15.
Lowy, L. (1979). Social work with the aging. New York: Harper and Row.
16.
Maddox, G. L. (1980). The continuum of care: Movement toward the community. In E. W. Busse & D. G. Blazer, (Eds.), Handbook of geriatric psychiatry. New York : Van Nostrand Reinhold.
17.
Moroney, R. M. (1980). Families, social services and social policy: The issue of shared responsibility. Washington, DC: U.S. Department of Health and Human Services.
18.
Moynihan, D. P. (1969). Maximum feasible misunderstanding: Community action in the war on poverty. New York: Free Press.
19.
Mundinger, M. O. (1983). Home care controversy: Too little, too late, too costly. Rockville, MD: Aspen Systems.
20.
Quadragno, J. S. (1984). From poor laws to pensions: The evolution of economic support for the aged in England and America. Milbank Memorial Fund Quarterly/ Health and Society, 62(3), 417-446.
21.
Perlman, R. (Ed.). (1983). Family home care: Critical issues for services and policies. New York: Haworth Press.
22.
Rappaport, J. S. (1977). Community psychology: Values, research and action. New York: Holt, Rinehart & Winston.
23.
Schmidtke, C. R. (1984). Values dilemmas confronting family care for the elderly. Paper presented at People-to-People Program in Dalian and Beijing, People's Republic of China.
24.
Steininger, M., Newell, J. D., & Garcia, L. T. ( 1984). Ethical issues in psychology. Homewood, IL: Dorsey Press.
25.
Tobin, S. S., & Kulys, R. (1980). The family and services. In C. Eisdorfer (Ed.), Annual review of geriatrics and gerontology (Vol. 1). New York: Springer.
26.
Vladeck, B. C. (1980). Unloving care: The nursing home tragedy. New York: Basic Books.
27.
Wyszewianski, L., & Donabedian, A. (1983). Equity in the distribution of care. In President's Commission for the Study of Ethical Problems in Medicine and Biomedical and Behavioral Research. Securing access to health care (Vol. 3). Washington, DC: Government Printing Office.
